Provider Demographics
NPI:1407555279
Name:STUKES, ROSALIND DENISE
Entity Type:Individual
Prefix:
First Name:ROSALIND
Middle Name:DENISE
Last Name:STUKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 234 L
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451
Mailing Address - Country:US
Mailing Address - Phone:910-338-8267
Mailing Address - Fax:
Practice Address - Street 1:101 CHARTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1807
Practice Address - Country:US
Practice Address - Phone:910-338-8267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)